ArticleAmerican journal of surgery2022
Increased complications in patients who test COVID-19 positive after elective surgery and implications for pre and postoperative screening.
Article in American journal of surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 50 citations in OpenAlex.
- Pharmacokinetic modelling during long-term anesthesia: minimizing the gap.Journal of advanced research · 2026Article
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- Impact of prior COVID-19 infection on perioperative outcomes in non-small cell lung cancer patients: a prospective observational cohort study.International journal of clinical oncology · 2025Observational
- Incidentally Diagnosed Asymptomatic COVID-19 Does Not Increase Total Complication Risk in Total Joint Arthroplasty.Arthroplasty today · 2025Article
- Age and clinical spectrum of COVID-19 are associated with safety of transarterial chemoembolization in hepatocellular carcinoma: a retrospective cohort study.Journal of gastrointestinal oncology · 2024Article
- Incidence of Postoperative Complications among Patients with Active or Resolved COVID-19 Undergoing Elective Abdominal Wall Reconstruction.Plastic and reconstructive surgery. Global open · 2024Article
- Impact of SARS-CoV-2 infection on short-term postoperative outcomes after gastroenterological cancer surgery using data from a nationwide database in Japan.Annals of gastroenterological surgery · 2024Article
- Article
- Considerations for Perioperative Thromboembolic Risk Mitigation in Actively and Recently COVID-19-Positive Patients Undergoing Hand Surgery.Journal of hand surgery global online · 2024Review
- The impact of COVID-19 for postoperative outcomes using a nationwide Japanese database of patients undergoing distal gastrectomy for gastric cancer.Annals of gastroenterological surgery · 2023Article
- Analysis of the short-term outcomes after esophagectomy for esophageal cancer during the COVID-19 pandemic using data from a nationwide Japanese database.Esophagus : official journal of the Japan Esophageal Society · 2023Article
- COVID-19 infection and ambulatory surgery: Decision making based on known knowns.Best practice & research. Clinical anaesthesiology · 2023Review
- Mid-term Surgery Outcomes in Patients With COVID-19: Results From a Nationwide Analysis.Annals of surgery · 2023Article
- Necrotizing Skin and Soft Tissue Infection after Gluteal Augmentation in a Perioperatively Asymptomatic COVID-19 Patient-Complications of the Post-Lockdown Era? A Case Report.Medicina (Kaunas, Lithuania) · 2023Article
- Association between COVID-19 and Postoperative Neurological Complications and Antipsychotic Medication Use after Cancer Surgery: A Retrospective Study.Journal of personalized medicine · 2023Article
- Biomarkers predicting the 30‑day mortality of patients who underwent elective surgery and were infected with SARS‑CoV‑2 during the post‑operative period: A retrospective study.Experimental and therapeutic medicine · 2022Article
- Partial COVID-19 vaccination associated with reduction in postoperative mortality and SARS-CoV-2 infection.American journal of surgery · 2022Article
- Perioperative COVID-19 in cardiac surgery: A toxic coexistence.Turk gogus kalp damar cerrahisi dergisi · 2022Article
- The influence of SARS-CoV-2 vaccination on post-operative outcomes in microsurgery patients.Microsurgery · 2022Article
- Perioperative Factors Impact on Mortality and Survival Rate of Geriatric Patients Undergoing Surgery in the COVID-19 Pandemic: A Prospective Cohort Study in Indonesia.Journal of clinical medicine · 2022Article
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundThe COVID-19 pandemic has necessitated the adoption of protocols to minimize risk of periprocedural complications associated with SARS-CoV-2 infection. This typically involves a preoperative symptom screen and nasal swab RT-PCR test for viral RNA. Asymptomatic patients with a negative COVID-19 test are cleared for surgery. However, little is known about the rate of postoperative COVID-19 positivity among elective surgical patients, risk factors for this group and rate of complications.
methodsThis prospective multicenter study included all patients undergoing elective surgery at 170 Veterans Health Administration (VA) hospitals across the United States. Patients were divided into groups based on first positive COVID-19 test within 30 days after surgery (COVID[-/+]), before surgery (COVID[+/-]) or negative throughout (COVID[-/-]). The cumulative incidence, risk factors for and complications of COVID[-/+], were estimated using univariate analysis, exact matching, and multivariable regression.
resultsBetween March 1 and December 1, 2020 90,093 patients underwent elective surgery. Of these, 60,853 met inclusion criteria, of which 310 (0.5%) were in the COVID[-/+] group. Adjusted multivariable logistic regression identified female sex, end stage renal disease, chronic obstructive pulmonary disease, congestive heart failure, cancer, cirrhosis, and undergoing neurosurgical procedures as risk factors for being in the COVID[-/+] group. After matching on current procedural terminology code and month of procedure, multivariable Poisson regression estimated the complication rate ratio for the COVID[-/+] group vs. COVID[-/-] to be 8.4 (C.I. 4.9-14.4) for pulmonary complications, 3.0 (2.2, 4.1) for major complications, and 2.6 (1.9, 3.4) for any complication. DISCUSSION: Despite preoperative COVID-19 screening, there remains a risk of COVID infection within 30 days after elective surgery. This risk is increased for patients with a high comorbidity burden and those undergoing neurosurgical procedures. Higher intensity preoperative screening and closer postoperative monitoring is warranted in such patients because they have a significantly elevated risk of postoperative complications.
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